2012 Volume 32 Issue 6 Pages 1013-1019
Between 2005 and 2010, we experienced 5 cases of torsion of the gallbladder, and examined useful findings for their preoperative diagnosis. We were able to diagnose 2 cases in 5 preoperatively, in which direct findings showing torsion of the gallbladder, such as the lack of contrast in the gallbladder wall on contrast-enhanced CT, the tapering and twisted cystic duct with coronal section image of contrast-enhanced CT, and disappearance of the bloodstream signal in the gallbladder wall on color Doppler sonography, were useful for the preoperative diagnosis. In addition, the following 7 factors were noted in all of 5 patients, including elderly female, lean figure, kyphosis, right hypochondrial pain in the physical examination, significant swelling of the gallbladder, floating gallbladder, and a high density area in the gallbladder wall suggesting hemorrhagic necrosis with an attenuation value ranging from 35 to 65 Hounsfield units on plain CT. It was thought that these were indirect findings seen with an increased frequency in torsion of the gallbladder. Our data suggested that, if these indirect findings were seen, they might lead to a preoperative diagnosis of torsion of the gallbladder when taken in combination with coronal section imaging on contrast-enhanced CT and color Doppler sonography.
